Bronchiolitis is a common lung infection in young children and infants. It causes swelling and irritation and a build-up of mucus in the small airways of the lung. These small airways are called bronchioles. Bronchiolitis is almost always caused by a virus.
Bronchiolitis starts out with symptoms much like a common cold. But then it gets worse, causing coughing and a high-pitched whistling sound when breathing out called wheezing. Sometimes children have trouble breathing. Symptoms of bronchiolitis can last for 1 to 2 weeks but occasionally can last longer.Most children get better with care at home. A small number of children need a stay in the hospital.
Symptoms of Bronchiolitis
During the initial days, bronchiolitis symptoms are quite similar to a common cold. This includes a runny nose, stuffy nose, cough, and sometimes a slight fever. Afterwards, your child may experience difficulty breathing and may wheeze for a week or more. It's worth noting that many infants with bronchiolitis also develop an ear infection called otitis media
What Causes Bronchiolitis?
Bronchiolitis happens when a virus infects the bronchioles, which are the smallest airways in the lungs. The infection makes the bronchioles swollen and irritated. Mucus collects in these airways, which makes it difficult for air to flow freely in and out of the lungs.
Bronchiolitis is usually caused by the respiratory syncytial virus (RSV). RSV is a common virus that infects just about every child by 2 years of age. Outbreaks of RSV infection often happen during the colder months of the year in some locations or the rainy season in others. A person can get it more than once. Bronchiolitis also can be caused by other viruses, including those that cause the flu or the common cold.
The viruses that cause bronchiolitis are easily spread. You can get them through droplets in the air when someone who is sick coughs, sneezes or talks. You also can get them by touching shared items — such as dishes, doorknobs, towels or toys — and then touching your eyes, nose or mouth.
Common Risk Factors
Bronchiolitis is a respiratory illness that commonly affects children under the age of 2 years. Infants younger than 3 months are at the highest risk of contracting bronchiolitis due to their underdeveloped lungs and limited ability to fight infections. Although rare, adults can also get bronchiolitis. Certain factors increase the risk of bronchiolitis in infants and young children. These include being born prematurely, having a heart or lung condition, a weakened immune system, exposure to tobacco smoke, contact with a large number of other children (such as in a child care setting), spending time in crowded places, and having siblings who attend school or child care services and may bring the infection home.
What are Complications of Bronchiolitis?
It's important to be aware of the potential complications that may arise from severe bronchiolitis, which include:
- Low levels of oxygen in the body
- Pauses in breathing, which are more common in premature babies and those under 2 months’ old
- Inability to consume enough liquids, leading to dehydration
- Inability to get enough oxygen, known as respiratory failure If any of these complications occur, it may be necessary for your child to receive hospital treatment.
In severe cases of respiratory failure, a tube may need to be inserted into the windpipe to help your child breathe until the infection improves.
How to Prevent Bronchiolitis?
Bronchiolitis can spread from person to person, it's crucial to wash your hands frequently to prevent infection. This is especially important if you have a cold, flu, or any other illness that can spread to your baby. In case you have any of these illnesses, ensure to wear a face mask. If your child has bronchiolitis, keep them at home until they recover completely to prevent its spread to others. Here are a few steps that could help prevent infection:
Limiting Contact
Limit contact with individuals who have a fever or cold. If your child is a new-born, particularly a premature new-born, make sure to avoid people with colds. This is especially important during the first two months of life.
Keep General Hygiene in Mind
Clean and disinfect surfaces that individuals regularly touch, such as toys and doorknobs. This is particularly important when a family member is ill. Be sure to also wash hands often. Frequently wash your hands and your child's hands with soap and water for at least 20 seconds. Keep an alcohol-based hand sanitiser handy to use when you're away from home. Ensure it contains at least 60% alcohol. Furthermore, it's important to use your own drinking glass. Don't share glasses with others, particularly if someone in your family is ill. Lastly, cover coughs and sneezes. Use a tissue to cover your mouth and nose, then throw it away, and wash your hands.
Breastfeed (If Possible)
It is important to try and breastfeed, when possible as studies have proven that respiratory infections are less common in breastfed babies.
Vaccines and Medications
There are no vaccines to prevent the most common causes of bronchiolitis, such as RSV and rhinovirus. But it's recommended that everyone older than six months gets a flu shot every year. Infants at high risk of RSV infection, such as those born prematurely or those with a lung condition or a weakened immune system, may be given the medicine palivizumab (Synagis). This medicine can decrease the risk of RSV infections.
When to See a Doctor
If your child has bronchiolitis and their symptoms become severe, seek medical attention right away if they:
- Have bluish or grayish skin, lips, or fingernails.
- Have difficulty breathing or cannot speak or cry.
- Refuse to drink enough or breathe too quickly to eat or drink.
- Breathe very quickly, with shallow breaths or inward movement of the ribs.
- Make wheezing or grunting sounds with each breath.